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Purpose: This case report examines the clinical presentation, diagnosis, treatment, and outcomes of mucocutaneous leishmaniasis with primary oral involvement in HIV-positive and HIV-negative patients diagnosed in Brazil., Methods: We discuss the clinical manifestations, diagnostic methods, and therapeutic strategies, highlighting the clinical and histopathologic diagnostic features and distinct progression patterns based on HIV status. Our findings are compared with patterns observed in other countries, emphasizing the differences between the Americas and Europe, Asia, and Africa., Results: In the Americas, particularly in Brazil, mucocutaneous leishmaniasis often presents with localized oral lesions, even in the presence of systemic immunosuppression, whereas in the Europe, Asia, and Africa, oral involvement is typically associated with visceral leishmaniasis in immunocompromised patients. These differences were due to variations in the parasite species involved., Conclusion: This comparison underscores the importance of regional and immunological factors in diagnosing and managing this neglected infectious disease., (© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

The present work reports a case of a female patient complaining of itching and painful lesions affecting the oral mucosa for 7 months. Buccal and lip mucosa showed swelling and erythema, with serpiginous tracks. The patient was diagnosed with oral larva migrans, and the lesions resolved after ivermectin administration. At 18-month follow-up, no sign of recurrence was observed. Larva migrans can represent a pitfall in oral diagnosis and a stressful condition for the patient. Oral health care providers should be aware of this and keep this disease in mind as a possible differential diagnosis in oral mucosa lesions.

Intubations are important live saving skills to maintain adequate ventilation and oxygenation. Common indications include impending upper airway obstruction, respiratory failure and impaired conscious level. Oral myiasis is an infrequently found disease which is characterised by ectoparasitic infestation of body tissues by fly maggots.We present a case report and share valuable experiences on a patient with massive airway myiasis causing upper airway obstruction which require emergency intubation., Competing Interests: Competing interests: None declared., (© BMJ Publishing Group Limited 2020. No commercial re-use. See rights and permissions. Published by BMJ.)

Diffuse cutaneous leishmaniasis is a rare chronic infectious disease, associated with Leishmania mexicana and L. amazonensis , presenting as multiple non-ulcerative painless nodules, with a tendency to relapse soon after treatment. We report a case of a 56-year-old Mexican woman exhibiting nodular lesions, plaques, crusts and scars involving the whole body. A solitary nodule was present at the junction between hard and soft palates. Diffuse cutaneous leishmaniasis is a disfiguring disease resulting in severe scarring if untreated.

Oral lesions focused around the oral commissures were documented in several Sharp-shinned Hawks ( Accipiter striatus ) in the 2016-18 spring migration season at a banding station located on the southern shore of Lake Ontario, New York, US. Samples of the inflamed and caseous lesions repeatedly tested negative for Trichomonas gallinae and poxvirus; however, large numbers of capillariid eggs and embedded worms were consistently present. Morphologically, the nematodes were identified as Eucoleus dispar , which was confirmed by PCR and genetic sequencing. The affected hawks displayed no other clinical signs of illness, were in good body condition, and were released back into their migration pathway shortly after examination and testing. We report a unique clinical presentation for oral capillariosis in A. striatus .

Dentists play a fundamental role in the early diagnosis of oral leishmaniasis. Although these lesions are rare at oral mucosa, this is one of the manifestations sites of the disease This study reports seven clinical cases of orofacial mucocutaneous leishmaniasis. All had leishmaniasis diagnosis confirmed by laboratory tests, with orofacial involvement. Five out of the seven cases were males, and in four cases, patients had associated comorbidities. Late diagnosis was observed, resulting in treatment delay and increased hospitalization stay. One patient had severe psychological consequences due to facial deformity. The lack of differential diagnosis due the great variability of clinical presentation of the lesions and frequent unspecific histopathology represent a challenge for the dentist. In two reported cases, there were unspecific biopsy results. This series of cases highlights the importance of a multidisciplinary approach in the diagnosis and treatment of oral and perioral leishmaniasis. Patients with atypical lesions, originating from or living in endemic regions, should be investigated for leishmaniasis. These procedures could avoid delays in diagnosis and decrease the risk of disease dissemination., Competing Interests: No competing interests were disclosed., (Copyright: © 2020 Falcão GGVSC et al.)

The dental surgeon plays a fundamental role in the early diagnosis of oral leishmaniasis, since oral mucosa may be the primary site of the disease manifestation. This study reports seven clinical cases of orofacial mucocutaneous leishmaniasis. All had mucocutaneous leishmaniasis with oropharyngeal involvement confirmed by laboratory tests. Five out of the seven cases were males, and in four cases, patients had associated comorbidities. Late diagnosis was observed, resulting in treatment delay and increased hospitalization stay. One patient had severe psychological consequences due to facial deformity. The lack of differential diagnosis due the great variability of clinical presentation of the lesions and frequent unspecific histopathology represent a challenge for the dental surgeon. In two reported cases, there were unspecific biopsy results. The multidisciplinary approach plays an important role in orofacial leishmaniasis diagnosis and treatment. Leishmaniasis should be investigated in case of atypical and persistent lesions in patients from endemic regions. This recommendation may avoid diagnosis delays and decrease dissemination of the disease., Competing Interests: No competing interests were disclosed., (Copyright: © 2019 Falcão GGVSC et al.)

The dental surgeon plays a fundamental role in the early diagnosis of oral leishmaniasis. Although these lesions are rare at oral mucosa, this is one of the manifestations sites of the disease This study reports seven clinical cases of orofacial mucocutaneous leishmaniasis. All had mucocutaneous leishmaniasis confirmed by laboratory tests, with orofacial involvement. Five out of the seven cases were males, and in four cases, patients had associated comorbidities. Late diagnosis was observed, resulting in treatment delay and increased hospitalization stay. One patient had severe psychological consequences due to facial deformity. The lack of differential diagnosis due the great variability of clinical presentation of the lesions and frequent unspecific histopathology represent a challenge for the dental surgeon. In two reported cases, there were unspecific biopsy results. This series of cases highlights the importance of a multidisciplinary approach in the diagnosis and treatment of oral and perioral leishmaniasis. Patients with atypical lesions, originating from or living in endemic regions, should be investigated for leishmaniasis. These procedures could avoid delays in diagnosis and decrease the risk of disease dissemination., Competing Interests: No competing interests were disclosed., (Copyright: © 2020 Falcão GGVSC et al.)

Dentists play a fundamental role in the early diagnosis of oral leishmaniasis. Although these lesions are rare at oral mucosa, this is one of the manifestations sites of the disease This study reports seven clinical cases of orofacial mucocutaneous leishmaniasis. All had leishmaniasis diagnosis confirmed by laboratory tests, with orofacial involvement. Five out of the seven cases were males, and in four cases, patients had associated comorbidities. Late diagnosis was observed, resulting in treatment delay and increased hospitalization stay. One patient had severe psychological consequences due to facial deformity. The lack of differential diagnosis due the great variability of clinical presentation of the lesions and frequent unspecific histopathology represent a challenge for the dentist. In two reported cases, there were unspecific biopsy results. This series of cases highlights the importance of a multidisciplinary approach in the diagnosis and treatment of oral and perioral leishmaniasis. Patients with atypical lesions, originating from or living in endemic regions, should be investigated for leishmaniasis. These procedures could avoid delays in diagnosis and decrease the risk of disease dissemination., Competing Interests: No competing interests were disclosed., (Copyright: © 2020 Falcão GGVSC et al.)

A juvenile Cinereous Vulture ( Aegypius monachus) fledgling was found disorientated on the roof of a building in Madrid City, Spain, in October 2016. A veterinary examination revealed multiple plaques distributed throughout the oropharyngeal cavity. Lesions were located under the tongue and at the choanal slit, hard palate, and esophagus opening and ranged from 2 to 7 mm, coalescing in areas up to 2 cm, with a yellowish color of the surface. Motile trichomonad trophozoites were detected in fresh wet mount smears from the lesions. Sequence analysis of the internal transcribed spacer (ITS)1/5.8S/ITS2 and small subunit ribosomal RNA confirmed that Trichomonas gypaetinii was the etiologic agent. Microbiologic cultures did not reveal any pathogenic bacteria or fungi. The animal recovered successfully after treatment with metronidazole and trimethoprim-sulfamethoxazole and was later released in a suitable habitat. Avian trichomonosis lesions caused by T. gypaetinii have not been reported.

The cysticercus is the larval form of the pork tapeworm. Oral cavity involvement of cysticercosis is rare but frequently reported from developing countries. This report presents 3 cases of oral cysticercosis involving the tongue and buccal mucosa in isolation. All 3 patients were treated with surgical excision and had an uneventful postoperative course. A brief review of the PubMed English-language literature search is presented. Oral cavity involvement with cysticercosis presents a diagnostic dilemma. Management is primarily surgical and carries an excellent prognosis., (Copyright © 2018 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.)

Myiasis is a pathological condition in which there is a pestilence of fly larvae feeding on living or dead tissues. This disease is common in the tropics and subtropics of Africa and America and rarely affects humans. Our case report describes a five-year-old boy from Karachi, Pakistan with a history of extraction sockets and incisional biopsy of the left parotid lymph node. Lack of proper wound maintenance led to infestation of maggots both over the overlying skin of the left parotid region and the posterior oral cavity. The plan was wound debridement both outside and intra-orally under local anesthesia and the removal of maggots. A cotton swab impregnated with turpentine oil was placed on the wounds for a few minutes. The wounds were then properly debrided with pyodine and hydrogen peroxide. Around 15 to 16 maggots were extracted from the wound on the left parotid region using medical forceps whereas five maggots were extracted from the intraoral wound with the help of turpentine oil and forceps. This case demonstrates the importance of oral health and proper wound management, and also that myiasis, despite its distinctiveness, can be managed by promoting awareness of the disease and by suitable treatment methods.

Gongylonema infection is a zoonotic disease occurring throughout the world and is mainly caused by consumption of contaminated water and raw food. Adult Gongylonema worms can exist as parasites in the human body for up to 10 years and cause symptoms of local irritation in the oral cavity, esophagus, and pharynx. Herein, we report a rare case in which live Gongylonema pulchrum was detected and extracted from the oral cavity of a woman. The pathogen was confirmed as G. pulchrum on the basis of microscopic examination and morphologic analysis. The patient's symptoms resolved immediately after surgical removal of the parasite, and the patient has been advised not to drink water that has not been boiled and to avoid consuming unwashed raw vegetables., (Copyright © 2017 Elsevier Inc. All rights reserved.)

Aims: Myiasis is a disease caused by the invasion of tissues by larvae of flies. The aim of this study was to carry out a review of reported cases of oral and maxillofacial myiasis in older adults and to show a case report of oral myiasis in a 95-year-old frail man with severe Alzheimer's disease from Brazil., Methods and Results: Between 1988 and 2017, 35 oral and maxillofacial myiasis cases were reported in older adults in English-language studies from PubMed and Lilacs databases., Conclusions: Oral and maxillofacial myiasis in older adults showed low incidence and good prognosis of cure, when there were no systemic complications. Weakness, frailty, dementia, oral lesions, labial incompetence, poor oral hygiene, and bad breath were associated with this disease in reported cases. Preferential therapy choices were debridement alone or combined with Ivermectin. In this case report, debridement and Ivermectin prescription was an effective therapy for an older adult with severe Alzheimer's disease., (© 2018 Special Care Dentistry Association and Wiley Periodicals, Inc.)

Background: Cutaneous leishmaniasis (CL) is underestimated in Spain as in other European countries due to the polymorphism of its clinical manifestations and histopathological features discouraging doctors from suspecting leishmaniasis. Mucosal manifestations (ML) are misdiagnosed due to the fact that they often mimic cancer., Objectives: Given that leishmaniasis may be masked as different granulomatous diseases in Leishmania infantum endemic areas, the aim of this study was to verify this misdiagnosing and contributes to the improvement of CL/ML diagnosis., Methods: A retrospective study involving formalin-fixed paraffin-embedded tissue biopsies with histopathological features of granulomatous lesions of unknown origin (GLUO) detected in 17 patients. This study included 13 patients with CL that was used as positive controls, nine patients with other confirmed diseases used as negative controls and seven patients with histological features suggestive of CL or ML without confirmation. Molecular analysis was blindly performed using two different PCR techniques., Results: The PCR detected 15 CL cases in which the diagnosis was neither clinically nor histologically suspected. Leishmaniasis was confirmed in seven suspected patients in whom the classical techniques failed to detect the parasite. L. infantum was identified in all cases. A systematic review of CL cases in GLUO patients from European countries identified 45 reported cases., Conclusions: In L. infantum endemic areas, a high percentage of GLUO are due to Leishmania infection. The main consequences are delayed diagnosis and underestimation of the real incidence. PCR performed on paraffin-embedded tissue proved to be a reliable tool for diagnosis of CL/ML and must be performed routinely in any granulomatous dermatitis, even when the morphological features are no stereotypical of leishmaniasis., (© 2017 European Academy of Dermatology and Venereology.)

Background: Pythiosis is a potentially fatal but non-contagious disease affecting humans and animals living in tropical and subtropical climates, but is also reasonably widespread in temperate climates, throughout the world. The most commonly reported affected animal species with pythiosis are equine and canine, with fewer cases in bovine and feline. Extracutaneous infections caused by Pythium insidiosum have been rarely described in the cat., Case Presentation: Sublingual pythiosis was diagnosed in a 2-year-old, male, Domestic Shorthair cat. The cat had a multilobulated, sublingual mass present for 3 months. Histopathological examination revealed severe multifocal coalescing eosinophilic granulomatous inflammation. Centers of the inflammation contained hyphae that were 3-7 μm-wide, non-parallel, uncommonly septate and rarely branching. The fungal-like organism was identified as P. insidiosum by polymerase chain reaction and subsequent amplicon sequencing., Conclusions: Only a few feline pythiosis cases have been reported and, when encountered, it usually causes granulomatous diseases of the skin or gastrointestinal tract. This case presents an unusual manifestation of feline pythiosis, representing the first involving the oral cavity in cats or dogs.

Introduction: The aim of this article is to present a rare case of myiasis caused by Dermatobia hominis. Myiasis is a disease caused by invasion of tissues of animals and humans by larval stages of dipterous (2-winged) flies. There are few reports of oral myiasis in the literature, mostly related to Cochliomyia hominivorax larvae. We present a case of a 53-year-old man with painful swelling of the left lower lip that was confirmed to be myiasis caused by D. hominis. Though more common in tropical and subtropical regions of North and South America, myiasis should be considered in the differential diagnosis of subcutaneous masses among residents or travelers in endemic areas.

The retrospective analysis of data on oral cavity clinical status in relation to microbiota species composition is presented. The research regards patients of different age, with and without congenital malformation, pretreatment assessed for occurrence of pathological changes in the masticatory system. Samples of the swabs collected from each patient (from dental plaque, periodontium and dental pockets) were used for identification of oral protozoans in wet slides and stained preparations; additionally, transmission electron microscope examination was performed. The material was used for in vitro cultures to identify bacteria strains. Clinically, intensity of tissue deteriorations was higher in patients with a congenital disease. Alive Trichomonas tenax and Entamoeba gingivalis, species with confirmed pathogenic impact on oral cavity and neighboring structures, were detected with higher prevalence in older patients. Enterococci, Staphylococcus aureus, various Enterobacteriaceae were more frequently detected in patients with somatic and mental retardations; in mouths of those patients, Klebsiella pneumonia and Pseudomonas aeruginosa opportunistic strains occurred. Masticatory system abnormalities favor colonization of oral cavity by exogenous species and dissemination of infections, especially dangerous for patients with congenital diseases. Oral microbiota assessment and preventive measures may be helpful to avoid subsequent peri-surgery complications.

Leech infestation is a very rare phenomenon in humans. It mostly occurs in humans when rural untreated water is drunk or while swimming in streams or lakes. When leeches adhere to the mucous membrane, they ingest blood. Thus, they can sometimes cause severe anemia that may require blood transfusion. We report a case that was referred to emergency service with bleeding in the floor of the mouth. A 10-year-old child was referred to the emergency service of a city hospital with a complaint of swelling in the floor of the mouth and spitting of blood. The patient was promptly taken to the operating room. Using local anesthesia, a surgical incision was made, and a moving, dark brown foreign body was removed from the floor of the mouth and identified as a leech. Leech endoparasitism should be considered as a cause of unexplained anemia due to bleeding from the throat. Accordingly, leech infestation must be considered in differential diagnosis when a patient complains of spitting of blood, hoarseness, or dysphagia.

Oral infections caused by helminths (worms) are rarely encountered in clinical practice, and consequently, there is a paucity of information in the medical and dental literature about these conditions. In the present article, we review the English literature related to oral helminthic infestations. The main oral infections caused by helminths include four roundworm (trichinosis, trichuriasis, filariasis, and larva migrans) and three tapeworm infections (cysticercosis, sparganosis, and echinococcosis). Cases are mainly encountered in endemic areas and mainly present a benign clinical picture. The diagnosis of oral helminthic infections is mostly established after histopathological examination, which shows parasitic larvae lined by fibrous tissue and inflammatory cells. Surgical excision is the preferred treatment of isolated oral lesions caused by helminths; however, patients should undergo thorough medical evaluation to exclude the possible involvement of other body systems., (© 2014 Wiley Publishing Asia Pty Ltd.)

Oral dirofilariasis is very rare with non-specific clinical manifestations. Here, we report the case of a 65-year-old South American woman with a submucosal nodule on her right buccal mucosa. The nodule was slightly tender and painful. Differential diagnoses included mesenchymal (lipoma or fibrolipoma, solitary fibrous tumor, and neurofibroma) or glandular benign tumors (pleomorphic adenoma) with secondary infections. We performed excisional biopsy. A histopathological examination revealed a dense fibrous capsule and a single female filarial worm showing double uterus appearance, neural plaque, well-developed musculature and intestinal apparatus. Dirofilariasis was diagnosed, and the patient was followed-up for 12 months without recurrence.

Primary mucosal leishmaniasis is a rare infectious disease, particularly in immunocompetent patients. We present a 50-year-old patient with a 6-week history of a painful lesion of the left buccal mucosa that mimicked cancer. The exophytic lesion looked invasive, and we took an incisional biopsy specimen to exclude cancer. The diagnosis of leishmaniasis was unexpected, and the patient was successfully treated with amphotericin B for five weeks. After five months the patient had a visceral recurrence. Chronic exophytic and ulcerated mucosal lesions that do not heal within 3-4 weeks should be regarded as the first signs of oral cancer, but primary oral leishmaniasis can easily mimic it., (Copyright © 2015 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.)

Midline destructive lesions have multiple possible etiologies, which can be grouped into neoplastic, infectious, or vasculitis-associated. The purpose of these case reports and literature review was to highlight the need to include mucocutaneous leishmaniasis in the diagnosis of midfacial lesions in any patient who has lived in Leishmania-endemic areas because this entity meets all of the clinical criteria to be considered a form of midline destructive lesion. We present two cases of mucocutaneous leishmaniasis that occurred in a Bolivian male immigrant and a European male traveler to Panama, in whom lesions were misdiagnosed as different midline destructive lesions with different causes (Wegener, vasculitis, and natural killer or T-cell lymphoma [NKTL]). The conclusion of our work is that all patients with midline destructive lesions should undergo histologic and molecular studies to be evaluated for mucosal leishmaniasis, particularly patients whose clinical history suggests this possibility. In cases of uvular involvement, biopsy of this region might be a possible alternative to nasal biopsy., (Copyright © 2015 Elsevier Inc. All rights reserved.)

Objective: To analyze retrospectively a case series of primary oral leishmaniasis and to review the literature on head-neck primary mucosal leishmaniasis (ML) in immunocompetent patients., Subjects and Methods: A PUBMED search was carried out from 1950 to 2013. Clinical records of patients with primary head-neck mucosal manifestations of leishmaniasis were analyzed. In addition, clinical records between 2001 and 2012 of patients with primary oral manifestations were collected in two independent hospitals., Results: Our multicenter case series revealed seven patients with oral leishmaniasis. The most commonly affected site was the tongue (four patients, 57%), and the most common clinical presentation was an exophytic lesion (six patients, 85%). The literature review showed 11 reports published between 2005 and 2013, describing 13 patients (100% male) affected by head-neck primary ML (54% laryngeal, 31% oral, 23% pharyngeal, and 15% endonasal). The most common clinical presentation was an exophytic lesion (69%)., Conclusions: The literature analysis revealed that in immunocompetent patients, the oral mucosa is the second most frequently affected site of the head and neck region. In the oral cavity, the tongue is the most affected site. Diagnosis of oral leishmaniasis represents a challenge but must be considered in any differential diagnosis of exophytic lesions of oral mucosa., (© 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Introduction: American tegumentary leishmaniasis (ATL) can affect the skin or mucosa (mucocutaneous leishmaniasis - MCL) including the oral cavity. MCL oral lesions are often confused with other oral diseases, delaying diagnosis and specific treatment, and increasing the likelihood of sequelae. Thus, increasing the knowledge of the evolution of ATL oral lesions can facilitate its early diagnosis improving the prognosis of healing., Objectives: Evaluate the frequency of ATL oral lesion and describe its clinical, laboratory and therapeutic peculiarities., Methods: A descriptive transversal study was carried out, using data from medical records of 206 patients with MCL examined at the outpatient clinics-IPEC-Fiocruz between 1989 and 2013. Proportions were calculated for the categorical variables and the association among them was assessed by the Pearson's chi-square test. Measures of central tendency and dispersion were used for the continuous variables and their differences were assessed by both parametric (t test) and non parametric (Mann-Whitney) tests. P-values <0.05 were considered as significant., Results: The most affected site was the nose, followed by the mouth, pharynx and larynx. Seventy eight (37.9%) have oral lesions and the disease presented a lower median of the evolution time than in other mucous sites as well as an increased time to heal. The presence of oral lesion was associated with: the presence of lesions in the other three mucosal sites; a smaller median of the leishmanin skin test values; a longer healing time of the mucosal lesions; a higher recurrence frequency; and a smaller frequency of treatment finishing and healing. When the oral lesion was isolated, it was associated with an age 20 years lower than when the oral lesion was associated with other mucosal sites., Conclusion: Considering the worst therapy results associated with the presence of oral lesions, we suggest that lesions in this location represent a factor of worse prognosis for MCL.

Oral infections caused by flies are rarely encountered in clinical practice, and consequently, there is a paucity of information in the medical and dental literature about these conditions. In the present article, we present a concise review on oral myiasis or fly-blown disease. A variety of fly species can infest the oral tissues and produce an exotic clinical picture. Oral myiasis is mainly encountered in the tropics and subtropics, but can also be encountered in the western part of the world due to the increase of globalization, immigration, and global warming. Commonly-reported symptoms of oral myiasis include pain, swelling, itchy sensation, and feeling of something moving in the mouth. The surgical debridement of infected tissue with the removal of maggots is the treatment of choice in most cases of oral myiasis., (© 2013 Wiley Publishing Asia Pty Ltd.)

The worldwide prevalence of leishmaniasis is increasing because of ecologic changes and increased medical profession awareness. Furthermore, solitary cases have been recently reported in Western countries. The authors describe the epidemiology, mode of transmission, and diagnosis of leishmaniasis and present 4 oral cases treated with systemic, localized, or combined therapy. The authors suggest that clinicians should maintain a high index of suspicion for atypical, resistant, oral and perioral lesions in individuals with a history of traveling in certain geographic regions. After diagnosis, treatment should be determined jointly by experts from the fields of oral and maxillofacial surgery, oral medicine, and dermatology based on leishmaniasis species and clinical presentation., (Copyright © 2014 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.)

Introduction: The term myiasis is applied to the injurious action that larvae of certain Diptera cause in vertebrate animals by growing in living or dead tissue. Because of its great destructive potential, appropriate and preventive treatment is necessary. Oral myiasis is a rare pathology in humans and is associated with poor oral hygiene, alcoholism, senility, suppurating lesion, severe halitosis, and other conditions., Method: We have presented a case of oral myiasis in a mentally challenged patient., Results: Reviewing the literature revealed that most of the cases involved the anterior part of the oral cavity of male patients living in developing or underdeveloped countries and also that predisposing factors invariably accompanied infestation.

Background: Although long known, infestations of the buccal mucosa by nematodes of the Gongylonema genus are rare, particularly in France. Herein we report a new case., Patients and Methods: A 48-year old man consulted for itching in various parts of the buccal mucosa over the preceding weeks. The patient lived in a rural region in southern Alsace and had never visited Africa. His work comprised overseeing the unloading of flour at the port of Basel. The initial clinical examination was negative. However, the patient managed to photograph a filament previously present in his buccal mucosa, and to ultimately extract a worm. The latter was identified at the Strasbourg Institute of Parasitology by Pr Pesson as a nematode of the genus Gongylonema sp. pulchrum. No other treatment was considered necessary., Discussion: It is important for dermatologists to be aware of this type of parasitosis. Its stereotyped clinical presentation allows ready diagnosis, but the possible absence of the parasite at the time of the visit may lead to a misdiagnosis of Ekbom syndrome (delusional parasitic infestation)., (Copyright © 2013 Elsevier Masson SAS. All rights reserved.)

We describe the thirteenth reported case of human infection with Gongylonema spp. in the United States and the first to be confirmed as Gongylonema pulchrum. The parasite described was isolated from the oral cavity of a resident of Williamsburg, Virginia. The identity of the parasite was verified through morphological and genetic approaches, and provided the first genetic confirmation of a Gongylonema sp. in humans.

The term myiasis refers to growth of parasitic diptera in the living or dead tissue of vertebrate animal. Most cases of myiasis in humans are mild and rarely present in the mouth. We describe 2 children with severe oral myiasis that evolved to oral and maxillofacial mutilations. We discuss preventive measures.

Cysticercosis is a common disease in developing countries, but oral lesions caused by this parasitic infestation are rare. We report here a rare case of oral cysticercosis in a 17 year old male who sought treatment for an asymptomatic nodule of the lower lip that had previously been diagnosed as a mucocele.

Cases of myiasis in man associated with preexisting lesions are quite common. However, in the forensic field, certain behavioral habits related to insects may be useful to ratify mistreatment. This is a register of a case of oral myiasis by Cochliomyia hominivorax (Diptera: Calliphoridae), an obligate parasite of warm-blooded animals, in a 95-year-old man with Alzheimer's and Parkinson's disease. The identification of immatures removed (n = 87) was based on their morphological characteristics. Considering the developmental time and length of the maggots, it was possible to estimate an infestation of at least 143 h. Undoubtedly, the poor state of health was one of the cofactors for the infestation; however, the long time of infestation observed denotes negligence in the conduct of patient care. In terms of prophylaxis, it would be recommended that individuals who need special care must have access to more comprehensive physical examinations and periodicals, as well as hygienic conditions should be meticulously observed. Additionally, the immatures causing myiasis after being removed must be stored and forwarded for analysis, since their identification can be crucial to determine the exact time and circumstances of an infestation, and consequently its pathogenesis. If we consider the aggressiveness of C. hominivorax, a fast and reliable diagnosis becomes even more important for an adequate treatment. Finally, it is expected that this study encourages the health care professionals to improve the treatment of incapable patients.

Introduction: The term leishmaniasis comprises a group of diseases caused by different protozoan species of the genus Leishmania. There are three main clinical forms of leishmaniasis: visceral, cutaneous and mucocutaneous. Exclusive involvement of the mucosa is very rare., Objectives: To present a case of mucocutaneous leishmaniasis in an elderly patient, discuss the clinical presentation, diagnostic process and treatment emphasizing the distinctions from other granulomatous lesions., Case Report: A 71-year-old male presenting with a symptomatic lesion on the hard and soft palate, which had developed over a period of 6 months was evaluated. The oral exam revealed a lesion with multiple ulcerated nodules on the hard and soft palate extending to the oropharynx. The diagnostic hypothesis was chronic infectious disease (paracoccidioidomycose, tuberculosis and leishmaniasis) or squamous cell carcinoma. Histopathological, histochemical and immunohistochemical analysis were performed. A chest x-ray revealed a normal pulmonary pattern. The Montenegro skin test was positive. The definitive diagnosis was leishmaniasis with exclusive oral manifestation and the patient was treated with liposomal amphotericin., Conclusions: Localized oral mucosa leishmaniasis is an uncommon event in an immunocompetent patient. Dentists play an important role in the diagnosis of oral leishmaniasis, which has systemic repercussions., (© 2012 The Gerodontology Society and John Wiley & Sons A/S.)

Background: Myiasis is the invasion of living tissue of humans and other mammals by eggs or maggots of flies of the order of Diptera. It occurs mainly in the Tropics and is associated with inadequate public and personal hygiene. Oral myiases in an older man appears to be rare., Objective: To relate a case of oral myiases in a debilitated older man treated by mechanical removal of the maggots, identifying the adult insect that caused the infestation., Methods: The diagnosis of oral myiasis was established by the clinical examination and it was detected that the infestation involved only soft tissue and the sinus cavity. The patient was submitted to two mechanical removal of the visible maggots., Results: Total of 110 maggots was removed from the oral cavity of the patient and adult insects was identified as belonging to the Calliphoridae Family, Cochliomyia hominivorax species. The patient died two days after the second procedure by severe systemic complications., Conclusions: The mechanic removal and the identification of the maggots must be adopted as soon as possible to prevent further tissue damage and bacterial infection in cases of oral myiasis. Special attention should be given to the debilitated old patients that are particularly susceptible to oral myiasis infestation., (© 2010 The Gerodontology Society and John Wiley & Sons A/S.)

Objective: The aim of this study was to describe a series of 10 cases of oral-maxillofacial myiasis, discussing its main features, demographic distribution, and treatment aspects., Study Design: A retrospective study was carried out involving male and female patients of any age with oral-maxillofacial myiasis. The sample was determined by spontaneous demand at the emergency ward of a hospital between January 2005 and January 2011 (6 years). After treatment of each case, data were gathered on the presence of associated systemic disorders, time elapsed since onset of the disease, and treatment established. A review of the literature on this topic was also carried out., Results: The sample was made up of 10 patients, all treated with surgical debridement whether or not associated with the use of oral ivermectin. Mean time elapsed since the onset of the disease ranged from 4 to 36 months. The middle third of the face was the most frequently affected region (7 cases). Oral-maxillofacial myiasis predominantly affected the male gender (70%)., Conclusions: Oral-maxillofacial myiasis affects individuals with poor hygiene and neurologic and/or psychologic alterations. It occurs predominantly in countries near the tropics. The treatment of choice is surgical debridement., (Copyright © 2011 Mosby, Inc. All rights reserved.)

Myiasis is the infestation of tissues and organs of animals and humans caused by the larvae of certain dipteran flies. It is more common in undeveloped and tropical countries and usually affects elderly patients, persons who are sick, and patients with mental illness. Oral myiasis is a rare pathologic condition and a risk to the patient's life because of its great destructive potential. Therefore, appropriate treatment is necessary. This article aimed to report a case of myiasis caused by Cochliomyia hominivorax in the palate of a patient with primary progressive aphasia, which was successfully treated through mechanical removal of larvae plus administration of ivermectin.

Human myiasis is a rare condition that is more common in regions with a warm and humid climate. The larvae involved in myiasis are voracious; they destroy healthy tissues and may cause serious haemorrhage. The condition can be life threatening. Six patients with craniofacial trauma and oral myiasis are reported. The diagnoses were made after larvae had been extracted. Treatment consisted of subcutaneous ivermectin therapy and the application of a phenol preparation (10% creolin) as a local measure for the control of larvae. After 12 (±1) days of hospitalization, no larvae remained in the patients' mouths and the patients were discharged. The laboratory identified the larvae as those of the fly Cochliomyia hominivorax. Healing was uneventful in the six cases presented, and no undesirable reactions were observed throughout the period of treatment. Although the usual treatment for myiasis involves surgical removal of the maggots, pharmacological therapies are emerging as effective alternatives., (© 2011 John Wiley & Sons A/S.)

Context: Mucosal leishmaniasis (ML) is a rare disease in the world, even in endemic areas such as Iran. Clinical, histologic, or cytologic assessment may help in the diagnosis of ML., Objective: To describe clinical, histologic, and cytologic findings in ML., Design: Review of our files showed 11 patients diagnosed with ML, of whom 7 patients had oral lesions, 1 of whom was a known patient with oral leishmaniasis with recurrence of oral lesions; 2 had laryngeal lesions; and 3 had nasal lesions. One case of laryngeal leishmaniasis was a recurrence of prior oral lesions. Cytologic smears were prepared by scraping the lesions with a scalpel or cytobrush. Histology on the biopsies was done for 7 patients. In 2 patients with nasal lesions, exfoliative cytology was made by washing the nasal cavity. Smears were both air dried and fixed in alcohol and stained., Results: Cytologic findings showed free Leishman-Donovan bodies, intrahistiocytic Leishman-Donovan bodies, atypical organisms, granuloma, acute and chronic inflammatory cells, histiocytes, multinucleated giant cells, mast cells, binucleated histiocytes (Reed-Sternberg-like cells), and plasma cells. In 6 of the patients, biopsy was inconclusive and in subsequent cytology the organism was detected. In 3 cases, findings from clinical and cytologic examinations were suggestive for leishmaniasis; however, with response to treatment, the diagnosis was confirmed. In 5 patients a malignant tumor was suspected because of clinical or histologic findings, but cytology helped to diagnose leishmaniasis., Conclusions: Clinically or histologically, ML can be mistaken for benign and malignant lesions. Scraping or exfoliative cytology is an easy, reliable, and cost-effective method for diagnosing ML. Thus, clinical, histologic, and cytologic features together may help in ML diagnosis.

Widespread mouth ulcerations were observed in largemouth bass collected from eight inland lakes in the Lower Peninsula of Michigan during the summer months of 2002 and 2003. These ulcerations were associated with, and most likely caused by, leech parasitism. Through the use of morphological dichotomous keys, it was determined that all leeches collected are of one species: Myzobdella lugubris. Among the eight lakes examined, Lake Orion and Devils Lake had the highest prevalence of leech parasitism (34% and 29%, respectively) and mouth ulcerations (53% and 68%, respectively). Statistical analyses demonstrated that leech and ulcer prevalence varied significantly from one lake to the other. Additionally, it was determined that the relationship between the prevalence of ulcers and the prevalence of leech attachment is significant, indicating that leech parasitism is most likely the cause of ulceration. The ulcers exhibited deep hemorrhagic centers and raised irregular edges. Affected areas lost their epithelial lining and submucosa, with masses of bacteria colonizing the damaged tissues. Since largemouth bass is a popular global sportfish and critical to the food web of inland lakes, there are concerns that the presence of leeches, damaged buccal mucosa, and general unsightliness may negatively affect this important sportfishery.

Cutaneous Larva migrans is a very common disease in tropical regions. In the oral mucosa, the infection occurs in the same way as in the skin, but it is rarer. This report describes two cases of Larva migrans in the oral mucosa. The first case was in a 27-year-old woman who presented an erythematous plaque located on the buccal mucosa, extending to a posterior direction, following a linear pattern, to other areas of the mouth. After incisional biopsy of the anterior-most portion of the lesion, morphological details obtained in multiple examined sections suggested Necator or Ancylostoma braziliense larvae as the cause of infection. The second case was in a 35-year-old male who presented a fusiform erythematous plaque in the palatal mucosa. This area was removed and submitted to microscopic examination under a presumptive diagnosis of "parasite migratory stomatitis". The histological characteristics were suggestive of a larva pathway. In both cases the lesion disappeared after biopsy and the patients were symptom-free.

Myiasis is a type of infection caused by the larvae of flying insects. This paper reports a case of a 72-year-old Caucasian man who was referred to the Infectology Department of Oswaldo Cruz University Hospital (Pernambuco-Brazil) for urgent treatment as he was malnourished and dehydrated. He had a facial and buccal lesion colonized with larvae and was extremely debilitated. The surgical and clinical treatment indicated at the first moment was the surgical removal of the larvae. But, after two days, some larvae were still present and therefore 12 mg of ivermectin was administered. At the end of the treatment, 601 larvae had been removed and the therapeutics established were suitable.

A 15-year-old girl presented with a chief complaint of bleeding from her nose. She had noticed worms emerging from her right nostril. She had a continuous dull ache on the right side of her nose, spreading over the maxillary sinus area, and on the infra-orbital margin on the same side. She complained of difficulty breathing through her right nostril and a foul smell, which was associated with orbital oedema. Intra-oral examination revealed erythema of the soft palate on the same side, which was tender on palpation. Her condition was diagnosed as nasal myiasis with orbital and palatal extension. Nasal myiasis was treated by surgical removal of the maggots and with Ivermectin and local application of turpentine. The symptoms resolved and the dangers of orbital complications and penetration into the intracranial cavity were averted. The serious short-term complications of nasal myiasis were prevented by prompt treatment.

Encephalitozoon cuniculi is an obligate intracellular pathogen that has a wide host distribution, but primarily affects rabbits. The aim of this study was to characterize both the cell-mediated and the antibody response in rabbits after experimental infection using 2 different infection routes: oral and ocular. SPF rabbits were infected with low (10³ spores) and high (10⁷ spores) infection doses. Monitored parameters included clinical signs, detection of spores in urine, antibody response detected with ELISA, and cell-mediated immunity detected by antigen-driven lymphocyte proliferation. At week 13 post-infection, half of the rabbits in each group were suppressed by intramuscular administration of dexamethasone. At week 18 post-infection, animals were euthanized. Clinical signs were mild with exacerbation after immunosuppression. Spores in urine and antigen-specific cell-mediated immunity were detected from weeks 5 and 4 post-infection, respectively. Specific IgM was detected 1 week after infection, and IgG antibodies followed 1 week later in rabbits infected with the high dose. Immunological responses were dose dependent. The authors can conclude that both oral and ocular experimental infection with E. cuniculi resulted in an immune response of the infected animals. Rabbits could be used as an experimental model for the study of ocular microsporidiosis.

Primary oral myiasis due to Chrysomya bezziana is a rare condition caused by invasion of tissues by larvae of the flies. A case of Oral myiasis is presented in a 12 year old boy with neuro-degenerative disease with seizures. Intra orally, a soft tissue pocket in the left buccal mucosa and a pocket under the palatal mucosa was seen containing maggots. Extra orally indurated erythematous swelling was present near the commissure of the mouth. Predisposing factors identified in the present case were mouth breathing, incompetent lips, low socioeconomic condition, malnutrition, and inability of the child to perform daily activities due to his neurodegenerative disease. Treatment consisted of manual removal of maggots following irrigation and application of turpentine oil along with a single dose Ivermectin 3 mg that was given systemically. Complete healing of the lesion was observed within 10 days without any recurrence for a follow up period of 1 year Medical personnel taking care of old / debilitated / unconscious patients need to bear in mind the possibility of Chrysomya bezziana infestation in them.